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Telpoukhovskaia MA, Liu K, Sayed FA, Etchegaray JI, Xie M, Zhan L, Li Y, Zhou Y, Le D, Bahr BA, Bogyo M, Ding S, Gan L. Discovery of small molecules that normalize the transcriptome and enhance cysteine cathepsin activity in progranulin-deficient microglia. Sci Rep 2020; 10:13688. [PMID: 32792571 PMCID: PMC7426857 DOI: 10.1038/s41598-020-70534-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 07/17/2020] [Indexed: 12/11/2022] Open
Abstract
Patients with frontotemporal dementia (FTD) resulting from granulin (GRN) haploinsufficiency have reduced levels of progranulin and exhibit dysregulation in inflammatory and lysosomal networks. Microglia produce high levels of progranulin, and reduction of progranulin in microglia alone is sufficient to recapitulate inflammation, lysosomal dysfunction, and hyperproliferation in a cell-autonomous manner. Therefore, targeting microglial dysfunction caused by progranulin insufficiency represents a potential therapeutic strategy to manage neurodegeneration in FTD. Limitations of current progranulin-enhancing strategies necessitate the discovery of new targets. To identify compounds that can reverse microglial defects in Grn-deficient mouse microglia, we performed a compound screen coupled with high throughput sequencing to assess key transcriptional changes in inflammatory and lysosomal pathways. Positive hits from this initial screen were then further narrowed down based on their ability to rescue cathepsin activity, a critical biochemical readout of lysosomal capacity. The screen identified nor-binaltorphimine dihydrochloride (nor-BNI) and dibutyryl-cAMP, sodium salt (DB-cAMP) as two phenotypic modulators of progranulin deficiency. In addition, nor-BNI and DB-cAMP also rescued cell cycle abnormalities in progranulin-deficient cells. These data highlight the potential of a transcription-based platform for drug screening, and advance two novel lead compounds for FTD.
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Affiliation(s)
- Maria A Telpoukhovskaia
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA.,Department of Neurology, University of California, San Francisco, CA, 94158, USA
| | - Kai Liu
- Gladstone Institute of Cardiovascular Disease, San Francisco, CA, 94158, USA
| | - Faten A Sayed
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA.,Department of Neurology, University of California, San Francisco, CA, 94158, USA.,Neuroscience Graduate Program, University of California, San Francisco, CA, 94158, USA
| | | | - Min Xie
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA.,Gladstone Institute of Cardiovascular Disease, San Francisco, CA, 94158, USA
| | - Lihong Zhan
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA.,Department of Neurology, University of California, San Francisco, CA, 94158, USA
| | - Yaqiao Li
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA
| | - Yungui Zhou
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA
| | - David Le
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA
| | - Ben A Bahr
- Biotechnology Research and Training Center, University of North Carolina At Pembroke, Pembroke, NC, 28372, USA
| | - Matthew Bogyo
- Department of Pathology, Stanford University, Stanford, CA, 94305, USA
| | - Sheng Ding
- Gladstone Institute of Cardiovascular Disease, San Francisco, CA, 94158, USA
| | - Li Gan
- Gladstone Institute of Neurological Disease, San Francisco, CA, 94158, USA. .,Department of Neurology, University of California, San Francisco, CA, 94158, USA. .,Helen and Robert Appel Alzheimer's Disease Research Institute, Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, 10021, USA.
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Carvalho de Freitas R, Lonien SCH, Malvezi AD, Silveira GF, Wowk PF, da Silva RV, Yamauchi LM, Yamada-Ogatta SF, Rizzo LV, Bordignon J, Pinge-Filho P. Trypanosoma cruzi: Inhibition of infection of human monocytes by aspirin. Exp Parasitol 2017; 182:26-33. [PMID: 28939444 DOI: 10.1016/j.exppara.2017.09.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 07/18/2017] [Accepted: 09/17/2017] [Indexed: 01/04/2023]
Abstract
Cell invasion by Trypanosoma cruzi and its intracellular replication are essential for progression of the parasite life cycle and development of Chagas disease. Prostaglandin E2 (PGE2) and other eicosanoids potently modulate host response and contribute to Chagas disease progression. In this study, we evaluated the effect of aspirin (ASA), a non-selective cyclooxygenase (COX) inhibitor on the T. cruzi invasion and its influence on nitric oxide and cytokine production in human monocytes. The pretreatment of monocytes with ASA or SQ 22536 (adenylate-cyclase inhibitor) induced a marked inhibition of T. cruzi infection. On the other hand, the treatment of monocytes with SQ 22536 after ASA restored the invasiveness of T. cruzi. This reestablishment was associated with a decrease in nitric oxide and PGE2 production, and also an increase of interleukin-10 and interleukin-12 by cells pre-treated with ASA. Altogether, these results reinforce the idea that the cyclooxygenase pathway plays a fundamental role in the process of parasite invasion in an in vitro model of T. cruzi infection.
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Affiliation(s)
- Rafael Carvalho de Freitas
- Laboratório de Imunopatologia Experimental, Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil
| | - Sandra Cristina Heim Lonien
- Laboratório de Imunopatologia Experimental, Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil
| | - Aparecida Donizette Malvezi
- Laboratório de Imunopatologia Experimental, Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil
| | - Guilherme Ferreira Silveira
- Laboratório de Virologia Molecular, Instituto Carlos Chagas - ICC/Fiocruz, Curitiba, 81350-010, Paraná, Brazil
| | - Pryscilla Fanini Wowk
- Laboratório de Virologia Molecular, Instituto Carlos Chagas - ICC/Fiocruz, Curitiba, 81350-010, Paraná, Brazil
| | - Rosiane Valeriano da Silva
- Laboratório de Imunopatologia Experimental, Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil
| | - Lucy Megumi Yamauchi
- Laboratório de Biologia Molecular de Microrganismos, Departamento de Microbiologia, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil
| | - Sueli Fumie Yamada-Ogatta
- Laboratório de Biologia Molecular de Microrganismos, Departamento de Microbiologia, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil
| | - Luiz Vicente Rizzo
- Hospital Israelita Albert Einstein, Avenida Albert Einstein 627-701, Subsolo Bloco A., 05651-901, São Paulo, São Paulo, Brazil
| | - Juliano Bordignon
- Laboratório de Virologia Molecular, Instituto Carlos Chagas - ICC/Fiocruz, Curitiba, 81350-010, Paraná, Brazil
| | - Phileno Pinge-Filho
- Laboratório de Imunopatologia Experimental, Departamento de Ciências Patológicas, Centro de Ciências Biológicas, Universidade Estadual de Londrina, 86051-970, Londrina, Paraná, Brazil.
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Machado-Silva A, Cerqueira PG, Grazielle-Silva V, Gadelha FR, Peloso EDF, Teixeira SMR, Machado CR. How Trypanosoma cruzi deals with oxidative stress: Antioxidant defence and DNA repair pathways. MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2016; 767:8-22. [DOI: 10.1016/j.mrrev.2015.12.003] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 12/22/2015] [Accepted: 12/23/2015] [Indexed: 02/06/2023]
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Nunes MP, Fortes B, Silva-Filho JL, Terra-Granado E, Santos L, Conde L, de Araújo Oliveira I, Freire-de-Lima L, Martins MV, Pinheiro AAS, Takyia CM, Freire-de-Lima CG, Todeschini AR, DosReis GA, Morrot A. Inhibitory effects of Trypanosoma cruzi sialoglycoproteins on CD4+ T cells are associated with increased susceptibility to infection. PLoS One 2013; 8:e77568. [PMID: 24204874 PMCID: PMC3810146 DOI: 10.1371/journal.pone.0077568] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Accepted: 09/03/2013] [Indexed: 01/16/2023] Open
Abstract
Background The Trypanosoma cruzi infection is associated with severe T cell unresponsiveness to antigens and mitogens characterized by decreased IL-2 synthesis. Trypanosoma cruzi mucin (Tc Muc) has been implicated in this phenomenom. These molecules contain a unique type of glycosylation consisting of several sialylated O-glycans linked to the protein backbone via N-acetylglucosamine residues. Methodology/Principal Findings In this study, we evaluated the ability of Tc Muc to modulate the activation of CD4+ T cells. Our data show that cross-linking of CD3 on naïve CD4+ T cells in the presence of Tc Muc resulted in the inhibition of both cytokine secretion and proliferation. We further show that the sialylated O-Linked Glycan residues from tc mucin potentiate the suppression of T cell response by inducing G1-phase cell cycle arrest associated with upregulation of mitogen inhibitor p27kip1. These inhibitory effects cannot be reversed by the addition of exogenous IL-2, rendering CD4+ T cells anergic when activated by TCR triggering. Additionally, in vivo administration of Tc Muc during T. cruzi infection enhanced parasitemia and aggravated heart damage. Analysis of recall responses during infection showed lower frequencies of IFN-γ producing CD4+ T cells in the spleen of Tc Muc treated mice, compared to untreated controls. Conclusions/Significance Our results indicate that Tc Muc mediates inhibitory efects on CD4+ T expansion and cytokine production, by blocking cell cycle progression in the G1 phase. We propose that the sialyl motif of Tc Muc is able to interact with sialic acid-binding Ig-like lectins (Siglecs) on CD4+ T cells, which may allow the parasite to modulate the immune system.
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Affiliation(s)
| | - Bárbara Fortes
- Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - João Luiz Silva-Filho
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | | | - Isadora de Araújo Oliveira
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Freire-de-Lima
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Ana Acacia Sá Pinheiro
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Christina Maeda Takyia
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Adriane Regina Todeschini
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - George Alexandre DosReis
- Carlos Chagas Filho Institute of Biophysics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alexandre Morrot
- Institute of Microbiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- * E-mail: (MPN); (AM)
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Martins RF, Martinelli PM, Guedes PMM, da Cruz Pádua B, dos Santos FM, Silva ME, Bahia MT, Talvani A. Protein deficiency alters CX3CL1 and endothelin-1 in experimentalTrypanosoma cruzi-induced cardiomyopathy. Trop Med Int Health 2013; 18:466-76. [DOI: 10.1111/tmi.12071] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Régia F. Martins
- Núcleo de Pesquisas em Ciências Biológicas; Universidade Federal de Ouro Preto; Ouro Preto; Brazil
| | - Patrícia M. Martinelli
- Departamento de Morfologia; ICB; Universidade Federal de Minas Gerais; Belo Horizonte; Brazil
| | - Paulo M. M. Guedes
- Departamento de Microbiologia e Parasitologia; Universidade Federal do Rio Grande do Norte; Natal; Brazil
| | - Bruno da Cruz Pádua
- Núcleo de Pesquisas em Ciências Biológicas; Universidade Federal de Ouro Preto; Ouro Preto; Brazil
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Caldas S, Caldas IS, Diniz LDF, Lima WGD, Oliveira RDP, Cecílio AB, Ribeiro I, Talvani A, Bahia MT. Real-time PCR strategy for parasite quantification in blood and tissue samples of experimental Trypanosoma cruzi infection. Acta Trop 2012; 123:170-7. [PMID: 22609548 DOI: 10.1016/j.actatropica.2012.05.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2011] [Revised: 04/30/2012] [Accepted: 05/08/2012] [Indexed: 01/23/2023]
Abstract
The lack of an accurate diagnosis has been a serious obstacle to the advancement of the anti-Trypanosoma cruzi chemotherapy and long-term infection can result in different health risks to human. PCRs are alternative methods, more sensitive than conventional parasitological techniques, which due to their low sensitivities are considered unsuitable for these purposes. The aim of this study was to investigate a sensitive diagnostic strategy to quantify blood and cardiac tissues parasites based on real-time PCR tools during acute and chronic phases of murine Chagas disease, as well as to monitor the evolution of infection in those mice under specific treatment. In parallel, fresh blood examination, immunological analysis and quantification of cardiac inflammation were also performed to confront and improve real-time PCR data. Similar profiles of parasitemia curves were observed in both quantification techniques during the acute phase of the infection. In contrast, parasites could be quantified only by real-time PCR at 60 and 120 days of infection. In cardiac tissue, real-time PCR detected T. cruzi DNA in 100% of infected mice, and using this tool a significant Pearson correlation between parasite load in peripheral blood and in cardiac tissue during acute and chronic phases was observed. Levels of serum CCL2, CCL5 and nitric oxide were coincident with parasite load but focal and diffuse mononuclear infiltrates was observed, even with significant (p<0.05) reduction of parasitism after 60 days of infection. Later, this methodology was used to monitor the evolution of infection in animals treated with itraconazole (Itz). Itz-treatment induced a reduction of parasite load in both blood and cardiac muscle at the treatment period, but after the end of chemotherapy an increase of parasitism was detected. Interestingly, inflammatory mediators levels and heart inflammation intensity had similar evolution to the parasite load, in the group of animals treated. Taken together, our data show that real-time PCR strategy used was suitable for studies of murine T. cruzi infection and may prove useful in investigations involving experimental chemotherapy of the disease and the benefits of treatment in relation to parasitism and inflammatory response.
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Guedes PMM, Gutierrez FRS, Silva GK, Dellalibera-Joviliano R, Rodrigues GJ, Bendhack LM, Rassi A, Rassi A, Schmidt A, Maciel BC, Marin Neto JA, Silva JS. Deficient regulatory T cell activity and low frequency of IL-17-producing T cells correlate with the extent of cardiomyopathy in human Chagas' disease. PLoS Negl Trop Dis 2012; 6:e1630. [PMID: 22545173 PMCID: PMC3335880 DOI: 10.1371/journal.pntd.0001630] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2011] [Accepted: 03/09/2012] [Indexed: 11/23/2022] Open
Abstract
Background Myocardium damage during Chagas' disease results from the immunological imbalance between pro- and production of anti-inflammatory cytokines and has been explained based on the Th1–Th2 dichotomy and regulatory T cell activity. Recently, we demonstrated that IL-17 produced during experimental T. cruzi infection regulates Th1 cells differentiation and parasite induced myocarditis. Here, we investigated the role of IL-17 and regulatory T cell during human Chagas' disease. Methodology/Principal Findings First, we observed CD4+IL-17+ T cells in culture of peripheral blood mononuclear cells (PBMC) from Chagas' disease patients and we evaluated Th1, Th2, Th17 cytokine profile production in the PBMC cells from Chagas' disease patients (cardiomyopathy-free, and with mild, moderate or severe cardiomyopathy) cultured with T. cruzi antigen. Cultures of PBMC from patients with moderate and severe cardiomyopathy produced high levels of TNF-α, IFN-γ and low levels of IL-10, when compared to mild cardiomyopathy or cardiomyopathy-free patients. Flow cytometry analysis showed higher CD4+IL-17+ cells in PBMC cultured from patients without or with mild cardiomyopathy, in comparison to patients with moderate or severe cardiomyopathy. We then analyzed the presence and function of regulatory T cells in all patients. All groups of Chagas' disease patients presented the same frequency of CD4+CD25+ regulatory T cells. However, CD4+CD25+ T cells from patients with mild cardiomyopathy or cardiomyopathy-free showed higher suppressive activity than those with moderate and severe cardiomyopathy. IFN-γ levels during chronic Chagas' disease are inversely correlated to the LVEF (P = 0.007, r = −0.614), while regulatory T cell activity is directly correlated with LVEF (P = 0.022, r = 0.500). Conclusion/Significance These results indicate that reduced production of the cytokines IL-10 and IL-17 in association with high levels of IFN-γ and TNF-α is correlated with the severity of the Chagas' disease cardiomyopathy, and the immunological imbalance observed may be causally related with deficient suppressor activity of regulatory T cells that controls myocardial inflammation. Dilated cardiomyopathy is one of the clinical forms of Chagas' disease (CD) after the infection caused by the parasite Trypanosoma cruzi. Even though strategies adopted in most Latin-American countries in the last decades towards vector control have been effective in reducing the incidence of CD, active transmission is maintained in some regions, and secondary prevention approaches are still required for the infected patients, mostly because the specific anti-parasitic medications are toxic and perhaps of limited efficacy in chronically infected individuals. Moreover, there are no markers to predict the risk of developing dilated cardiomyopathy in asymptomatic, chronically infected patients, although the failure in the mechanisms that control the immune response can be involved in the development of Chagas' heart disease. In this study we show that preserved activity of regulatory T cells and the production of the cytokine IL-17 are connected with a more benign evolution of the disease, which brings a new understanding on the mechanisms associated with progression of CD.
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Affiliation(s)
- Paulo Marcos Matta Guedes
- Department of Microbiology and Parasitology, Federal University of Rio Grande do Norte, Natal, Brazil
- Department of Biochemistry and Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Fredy Roberto Salazar Gutierrez
- Department of Biochemistry and Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
- School of Medicine, University Antonio Narino, Bogota, Colombia
| | - Grace Kelly Silva
- Department of Biochemistry and Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Renata Dellalibera-Joviliano
- Integrated Faculty Fafibe and Department of Surgery and Anatomy, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Gerson Jhonatan Rodrigues
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Lusiane Maria Bendhack
- Department of Physical and Chemistry, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Anis Rassi
- Division of Cardiology, Anis Rassi Hospital, Goiânia, Brazil
| | - Anis Rassi
- Division of Cardiology, Anis Rassi Hospital, Goiânia, Brazil
| | - André Schmidt
- Division of Cardiology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - Benedito Carlos Maciel
- Division of Cardiology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - José Antonio Marin Neto
- Division of Cardiology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
| | - João Santana Silva
- Department of Biochemistry and Immunology, School of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil
- * E-mail:
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Molecular diversity of the Trypanosoma cruzi TcSMUG family of mucin genes and proteins. Biochem J 2011; 438:303-13. [PMID: 21651499 DOI: 10.1042/bj20110683] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The surface of the protozoan Trypanosoma cruzi is covered by a dense coat of mucin-type glycoconjugates, which make a pivotal contribution to parasite protection and host immune evasion. Their importance is further underscored by the presence of >1000 mucin-like genes in the parasite genome. In the present study we demonstrate that one such group of genes, termed TcSMUG L, codes for previously unrecognized mucin-type glycoconjugates anchored to and secreted from the surface of insect-dwelling epimastigotes. These features are supported by the in vivo tracing and characterization of endogenous TcSMUG L products and recombinant tagged molecules expressed by transfected parasites. Besides displaying substantial homology to TcSMUG S products, which provide the scaffold for the major Gp35/50 mucins also present in insect-dwelling stages of the T. cruzi lifecycle, TcSMUG L products display unique structural and functional features, including being completely refractory to sialylation by parasite trans-sialidases. Although quantitative real time-PCR and gene sequencing analyses indicate a high degree of genomic conservation across the T. cruzi species, TcSMUG L product expression and processing is quite variable among different parasite isolates.
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Talvani A, Teixeira MM. Inflammation and Chagas disease some mechanisms and relevance. ADVANCES IN PARASITOLOGY 2011; 76:171-94. [PMID: 21884892 DOI: 10.1016/b978-0-12-385895-5.00008-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Chagas cardiomyopathy is caused by infection with flagellated protozoan Trypanosoma cruzi. In patients, there is a fine balance between control of the replication and the intensity of the inflammatory response so that the host is unable to eliminate the parasite resulting in the parasite persisting as a lifelong infection in most individuals. However, the parasite persists in such a way that it causes no or little disease. This chapter reviews our understanding of many of the mediators of inflammation and cells which are involved in the inflammatory response of mammals to T. cruzi infection. Particular emphasis is given to the role of chemokines, endothelin and lipid mediators. Understanding the full range of mediators and cells present and how they interact with each other in Chagas disease may shed light on how we modulate disease pathogenesis and define new approaches to treat or prevent the disease.
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